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#652 of 11K

81513

HCPCS Procedure Code

HCPCS code 81513 is the #652 most-billed Medicaid procedure code, with $114.2M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $71.32.

Total Paid

$114.2M

0.01% of all spending

Total Claims

2.0M

Providers

429

Avg Cost/Claim

$57

National Cost Distribution

How much do providers bill per claim for 81513? Based on 385 providers billing this code nationally.

Median

$71.32

Average

$73.81

Std Dev

$53.42

Max

$452.76

Percentile Distribution (Cost per Claim)

p10
$11.22
p25
$32.22
Median
$71.32
p75
$103.44
p90
$131.64
p95
$154.96
p99
$233.43

50% of providers bill between $32.22 and $103.44 per claim for this code.

90% bill between $11.22 and $131.64.

Top 1% bill above $233.43.

About This Procedure

HCPCS code 81513 was billed by 429 providers across 2.0M claims, totaling $114.2M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$71.32

Providers Billing

385

National Spending

$114.2M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 81513

#ProviderTotal Paid
1Quest Diagnostics Llc Il

Wood Dale, IL · Clinical Medical Laboratory

$11.2M
2Quest Diagnostics Llc

Marlborough, MA · Clinical Medical Laboratory

$7.1M
3Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$6.4M
4The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$6.3M
5Quest Diagnostics Clinical Laboratories Inc

Irving, TX · Clinical Medical Laboratory

$4.8M
6Quest Diagnostics Incorporated

Clifton, NJ · Clinical Medical Laboratory

$4.1M
7Quest Diagnostics Llc Il

Schaumburg, IL · Clinical Medical Laboratory

$4.0M
8Quest Diagnostics Massachusetts Llc

Marlborough, MA · Clinical Medical Laboratory

$3.5M
91881697464$3.2M
10Labone Llc

Lenexa, KS · Clinical Medical Laboratory

$3.0M
11A2cl Services, Llc

West Allis, WI · Clinical Medical Laboratory

$2.7M
12Unilab Corporation

Sacramento, CA · Clinical Medical Laboratory

$2.5M
131801826680$2.1M
14Sonora Quest Laboratories Llc

Phoenix, AZ · Clinical Medical Laboratory

$1.8M
15Presbyterian Healthcare Services

Albuquerque, NM · Emergency Medicine

$1.7M
16Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$1.7M
171891873303$1.6M
18Quest Diagnostics Clinical Laboratories Inc

Miramar, FL · Clinical Medical Laboratory

$1.6M
19Quest Diagnostics Clinical Laboratories Inc

Tucker, GA · Clinical Medical Laboratory

$1.5M
20Tricore Inc.

Albuquerque, NM · Clinical Medical Laboratory

$1.4M

Showing top 20 of 429 providers billing this code